AUTHOR=Podestá Miguel Luis , Podestá Miguel 

TITLE=Megaprepuce Reconstruction: A Single Center Experience

JOURNAL=Frontiers in Pediatrics

VOLUME=6

YEAR=2018

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2018.00064

DOI=10.3389/fped.2018.00064

ISSN=2296-2360

ABSTRACT=<sec id="ST1"><title>Introduction</title><p>Surgical treatment of congenital megaprepuce is challenging and controversial. We report our 10-year experience treating patients with this deformity using a standardized procedure that has similarities to a technique reported by Smeulders et al. (<xref ref-type="bibr" rid="B1">1</xref>). Our postoperative complications and mid-term follow-up cosmetic appearance of the genitalia after reconstruction are reviewed.</p></sec><sec id="ST2"><title>Material and methods</title><p>Fifteen patients operated on between 2005 and 2015 were evaluated. Age at surgical repair ranged from 3 to 20 months (mean 9). Treatment included unfolding the preputial sac <italic>via</italic> a ventral approach, excision of redundant inner preputial skin, and ventral skin coverage with the outer preputial layer. Twelve patients presented associated partial scrotal engulfment, which was simultaneously treated. Mean follow-up was 4.6 years (range 2–7 years).</p></sec><sec id="ST3"><title>Results</title><p>Short-term complications occurred in three patients: scrotal hematoma in one patient and small skin dehiscence at the penoscrotal junction in two patients. Skin disruption healed by secondary epithelial ingrowth. All cases resulted in a satisfactory genital cosmetic outcome. There were no late complications. All patients preserved normal external genitalia appearance.</p></sec><sec id="ST4"><title>Conclusion</title><p>Our experience is in agreement with reports of other authors; suggesting that excision of the inner preputial layer and using the external one for penile coverage provide good and durable mid-term esthetic results in megaprepuce reconstruction.</p></sec>